1 / 42

Predictors of Obesity in School Aged Jordanian Adolescents

Predictors of Obesity in School Aged Jordanian Adolescents. Dr . Mousa Ali Al- Hassan Dr . Erika Sivarajan Froelicher. BY Dr . Manal Ibrahim Al -Kloub. Background.

ciara
Download Presentation

Predictors of Obesity in School Aged Jordanian Adolescents

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Predictors of Obesity in School Aged Jordanian Adolescents Dr. Mousa Ali Al- Hassan Dr. Erika Sivarajan Froelicher BY Dr. Manal Ibrahim Al -Kloub

  2. Background • Jordan is moving through nutrition transition. Demographic, epidemiological, economic and social changes have been associated with changes in diet, food expenditure and general health (Bloom, et al., 2001; Madanat, et al., 2008). • Adolescence is a developmental stage in which many behaviors are acquired including health behaviors

  3. Problem Statement • The prevalence of overweight and obesity is rising worldwide and regionally ( WHO, 2002 Report). • In Jordan, 17.5% of male and female adolescents are either overweight or obese. (GSHS, 2007). • Of the Jordanian population, 59% are under the age of 25 years old, of whom the largest age group are those between 10 and 18 years old • International literature have demonstrated that socio-demographics and health behaviors, eating habit and physical activity, contribute to obesity; however,

  4. Problem Statement • Studies on the factors that lead to the development of obesity in Jordanian adolescents are limited • The few available studies have focused on male adolescence and did not include the effect of socio-demographics

  5. Significance of the Study • Obesity has been looked at as a risk factor for morbidity and mortality of adolescents; it contribute to increased health costs for families and health care system (Dietz, 1998; Decelbaum and Williams, 2001) • Health habits and lifestyles established in adolescence are likely to continue throughout life, and obese adolescents tend to be obese adults; facing an increased risk for diabetes, cardiovascular diseases , orthopedic problems and many other chronic diseases. (Dietz, 1998).

  6. Significance of the study continued • Therefore, identification of factors that contribute to adolescents’ obesity is essential for community health nurses . This information my help the nurses to develop educative counseling programs to overcome the problem of obesity.

  7. Purpose of the study The major purposes of the study were to • Assess activity levels and eating behavior of adolescents • Examine the significance of socio-demographics and health behaviors in predicting obesity in adolescents

  8. Research Questions • What are the frequencies of obesity and overweight in Jordanian adolescents aged 15 or 16 years? • What are the eating habits, and physical activity levels in adolescents aged 15 or 16 years? • Do boys and girls differ in dietary patterns, physical activity, and weight status? • What is the significance of socio-demographics and health behaviors (eating behaviors and activity level) in predicting obesity.

  9. Factors Contributing to the Development of Overweight and Obesity Obesity occurs when there is an energy imbalance of more calories consumed than expended over an extended period, usually due to multiple factors

  10. Factors Continued The following factors were found in the literature as important contributors to obesity: • Genetic • Biological • Socioeconomic status • Dietary intake • Life style factors • Environmental changes (Kimm and Obarzanek, 2002;Blasi, 2003; Reilly, et al., 2004)

  11. Factors Continued The individual behaviors have been identified as key issue in the development of obesitysuch as • Increased consumption of high caloric foods • Decreased physical activity and increased sedentary activities (Kimm and Obarzanek, 2002; WHO Technical Report, 2003)

  12. Resarch Methodology • Design: A cross-sectional design of a school based survey • Setting: All public schools in the four (4) educational directorate in the capital city, Amman

  13. Sample Size Calculations The required sample size was calculated based on • Proportions • Effect size Total sample participated in the study was 518

  14. Sampling • Cluster consecutive sampling technique was used in which • Two simple random sampling was employed to select • 8 schools from the four public directorates ( 4 boys & 4 girls) • 12 classrooms from 39 classrooms(6 boys & 6 girls) • All students in each class were approached to participate

  15. Inclusion Criteria The study population was Jordanian boys and girls school of adolescents aged 15 or 16 years, and living in Amman.

  16. Exclusion Criteria • Limitations in physical activity due to health problems (i.e., musculoskeletal or neurological problems ) • Medical diagnosis of endocrine or metabolic disorders that required current medical treatments (i.e., Thyroid disease or diabetes mellitus).

  17. Ethical Consideration • The University of Jordan Committee on Human Research reviewed and approved this study • Permission were obtained from MOE, each public educational directorate, and from each participating school. • A signed consent form was also obtained from parents of all participating adolescents

  18. Procedure • The required data were collected in two steps, questionnaire distribution, followed by anthropometric measurements • Well trained, baccalaureate nurse assisted the primary investigator in data collection. The Interrater reliability was 0.99

  19. Measurements • Weights and heights of adolescents were measured according to a standardized protocol • BMI was calculated asBMI = kg/m2 • Overweight and obesity were defined according to the Cole et al. (2000 ) international cut-points of BMI for boys and girls between 2 and 18 years of age

  20. The Questionnaires Students completed a brief-self report questionnaire in 15 minutes during the classroom period and recorded their responses directly on 2 parts questionnaires: • Sociodemographic • General School Health Survey (GSHS) usedtoassess the dietary, physical activity and inactivity behaviors

  21. Sociodemographic Questionnaire • It consisted of 14 questions assessing adolescent's age, gender, family structure, socioeconomic status and family health condition

  22. The General School Health Survey Questionnaire(GSHS) • Developed by CDC based on YRBS questionnaire • Pre-tested in numerous parts of the world • Measure the prevalence of important behavioral risk and protective factors among adolescents • it consisted of 22 question on dietary habits and 10 questions on physical activity and inactivity • The validity and reliability of (GSHS) is presented based on the YRBS questionnaire. • Test -retest reliability was (61% -100%)

  23. Data Management and Analysis Plan • The Statistical Package of Social Sciences (SPSS) version13 was used • Descriptive statistics :to describe the demographic sample characteristics (age, gender, and socioeconomic ). • Chi-square :to identify the association between each of the study factors and outcome • Multivariate logistic regression to explore determinants of excess weight

  24. Results Main data Findings

  25. Frequency of weight status for the total sample and for adolescent boys and girls

  26. Relation ship between socio-demographic , dietaryfactors on weight (n = 501)

  27. Discussion • The current study provides evidence that excess weightis a common problem among Jordanian adolescents • The frequency of excess weight in this study exceeds the frequency reported by a most recent national GSHS by 53 % with one out of every one and half adolescents being overweight

  28. Discussion continued • In the current study there was no significant relationship between gender and • Excess weight • Dietary factors • Physical activity • This study supports the finding from previous one that gender is not an important factor in predicting excess weight in adolescents(Whitaker and Orzol ,2006)

  29. Limitations • A cross- sectional design is considered a weak design in relation to causality • The generalizability of the findings is limited to • Boys and girls ages 15 and 16 years • Public schools in Amman area

  30. Limitations Continued • The possibility that BMI has failed to distinguish between fat and fat-free mass (muscle and bone), suggesting that the index could exaggerate obesity in large and muscular boys

  31. Limitations Continued • Information bias may have resulted in an overestimation of healthy behaviors (fruit intake, physical activity) and an underestimation of unhealthy behaviors (fat and soft drink consumption).

  32. Limitations Continued • Dietary information was only obtained on the frequency and not on the total volume for these variables. • Physical activities did not include any variables related to the frequency, intensity, and duration of physical activities of adolescents.

  33. Implications Practice In order to counter the rise in obesity prevalence: • Multi-dimensional effective intervention programs that combine education, counseling and behavioral skill building along with environmental support should be developed. • Intervention strategies should be directed not only to adolescents, but should also include the whole family.

  34. Practice Continued • School-based interventions are thus assumed to have positive effects on adolescents’ eating and physical activity behaviors

  35. Education • The medical community must be educated in the identification and implementation of aggressive interventions. • Parents and school personnel need to be educated to promote and direct efforts to support strategies to maintain healthy eating and exercise as a lifestyle for adolescent, families and society.

  36. Education Continued • Adolescents needed to be educated as to habits that constitute a healthy diet, exercise, and weight status. • Schools of nursing reevaluate their curriculum to include education for students and faculty on the, prevention, screening and treatment of overweight in adolescents and families in their communities

  37. Education Continued • City and community planning play an important role as a governmental priority to build healthy communities with opportunities for exercise and physical activities near residential neighborhoods.

  38. Research • This data demonstrated a need to evaluate more closely the affect of family dynamics on the development of overweight and obesity in adolescents. • A prospective study with adequate funding should examine trends and relationships between weight, physical activity, and dietary variables in adolescents with rigorous methods for data collections

  39. Conclusion • Substantial evidence exists regarding the importance of overweight and obesity problem found among adolescents • Socio-demographic variables and parental obesity have a greater influence on the frequency of overweight or obesity among adolescents than dietary and physical activity practices

  40. Conclusion Continued • A careful strategy that helps adolescents control overweight and obesity would be beneficial to help reduce this alarming and serious “obesity” and help maintain normal body weight. • The prevention and treatment of overweight in school-aged adolescents requires increased efforts and partnerships at all levels

  41. Thank You Manal Kloub

More Related